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Correlation of grayscale combined with color doppler sonography from histopathology in predicting retained products of conception

Jeptah Komiya-Padilla, MD, FPOGS and Leilani Go-Suva, MD, FPOGS, FPSUOG
Department of Obstetrics and Gynecology, Dr. Jose Fabella Memorial Hospital

Background: Retained products of conception can be troublesome complications following miscarriages. Ultrasound has a significant impact in their diagnosis and with the advent of color doppler sonography can improve the assessment.

Objective: The goal of this study was to evaluate the use of grayscale combined with color Doppler ultrasound findings and correlate with histopathology in predicting retained products of conception in a maternity hospital.

Methods: This was a cross sectional prospective study of 109 patients who underwent transvaginal grayscale ultrasound with color Doppler to evaluate the presence of retained products of conception. Resistance index(RI) is measured in Pulsed doppler to assess the impedance of blood flow. The standard criterion was the histopathologic reports obtained during completion curettage.

Results: Histopathologic results validated the presence of immature placental tissues in 93 (85%) patients and decidua in 16 (15%). Endometrial mass was greater with positive histopath results (p<0.05). Endometrial mass had a sensitivity of 83.9% in detecting retained products of conception. Thickened endometrium was detected in 71.4 % of women with positive histopath results, but only in 28.6% with negative histopath results. Color flow was confirmed in 85% with positive histopathology results.

Conclusion: The combination of an endometrial mass with vascular pattern had the highest positive predictive value in determining retained products of conception.